This thought-provoking book exposes and challenges the hidden assumptions of modern medicine: the body is a kind of machine; symptoms must be caused by disease; health depends on healthcare; prevention is better than cure; things that can be measured are more real than others; how we see things is how they are; relationships are peripheral to medical care; proper doctors just keep going. It encourages readers to reconsider how they think about health and the wider healthcare system, and how to look after patients, themselves and each other as clinicians.
Recognising that many of the problems in the NHS and other healthcare systems are complex and not just due to overwhelming demand or staff shortage, the articles in this collection draw attention to the gap between our understanding of these issues and our everyday experience. Using vivid analogies and colourful characters, the author invites readers to fit the pieces together and look at the bigger picture that emerges.
The book is intended as a tonic for clinically active GPs in training and beyond who deal with the consequences of small picture thinking on a daily basis. It will also be of interest to GP trainers, including course organisers and those involved in curriculum development, and other primary care health professionals and administrators.
Part 1: How We Think About Things 1. Naming 2. Learning to Live with Cognitive Bias 3. Making it Real 4. Telling a Good Story 5. Seeing the Tiger 6. A Tyranny of Nouns 7. Timber, Trees and Sawdust 8. Codes 9. Beware of Little Worlds 10. Avoiding Death 11. How to Make a Decision 12. Narrative and Numbers 13. Illusions of Control 14. Swiss Cheese and the Power of Saying Sorry 15. The Cliff and the Bog 16. Imaginary Medical Solutions Part 2: How the System Works 17. The USP of General Practice 18. Hummingbirds and Foxes 19. One Big Thing 20. Facing Both Ways 21. Looking In and Looking Out 22. Living in the Third Age of Medicine 23. Networks, Nodes and Equilibrium 24. Efficiency, Effectiveness and Communities of Practice 25. Imagining the Future 26. Not Just a Theory 27. Diverging at the Horizon 28. Health Perception 29. Wagging the Dog 30. Cautionary Tales 31. A Poisoned Chalice 32. The Deal Part 3: How We Look After Patients 33. Heroes with Bifocals 34. Flag-Waving and Learning to Dance 35. Falling Off the Swing 36. Getting On with Strangers 37. Kobayashi Maru 38. Hyper-Burgers, Hyper-Medicine, and Making Sense of It All 39. Sick Notes and Culture 40. Seeing and Hearing 41. Scientists After All 42. Retrospectoscopy 43. Relational Care 44. Uncertainty, Placebos, and Travelling with Confidence 45. Medically Explained Symptoms 46. Eating the Elephant or Riding It 47. Ripples on a Pond 48. Having Mental Health 49. Irresistible and Immovable Values 50. Archery, Noodles, and General Practice 51. Narrative Failure Part 4: How We Look After Ourselves and Each Other 52. Keeping Behind the Curve 53. Rethinking Continuity 54. Professionalism, Kindness, and Going the Extra Mile 55. Being Human 56. Overcoming the Monster 57. Making It Look Easy 58. Pulp Fiction: Resilience, or Something Else
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